Nocebo hyperalgesia and the startle response

Aslaksen, Per M.; Åsli, Ole; Øvervoll, Morten; Bjørkedal, Espen

doi:10.1016/j.neuroscience.2016.10.040

Cited by 16 publications

(10 citation statements)

References 37 publications

(40 reference statements)

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“…The test started at baseline temperature (32°C), increased by 10°C/s and kept a stable temperature of 47,5°C for 30 s, before returning to baseline. The target temperature was selected based on previous studies in our lab showing that a tonic heat stimuli >47°C is rated as painful in most healthy participants ( Aslaksen et al, 2014 , 2016 ). Upon finishing the two intensity tests, the thermode was moved 2 cm from the original spot toward the elbow, to avoid hyperalgesia.…”

Section: Methodsmentioning

confidence: 99%

Pain Processing in Elite and High-Level Athletes Compared to Non-athletes

2020

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Background: Previous studies shows that elite and high-level athletes possess consistently higher pain tolerance to ischemic and cold pain stimulation compared to recreationally active. However, the data previously obtained within this field is sparse and with low consistency. Purpose: The aim of the present study was to examine the difference in pain perception between elite and high-level endurance athletes (cross country skiers and runners), elite soccer players and non-athletes, as well to explore the impact of psychological factors on pain processing. Methods: Seventy one healthy volunteers (33 females and 38 males) participated in the study. Soccer players (n = 17), cross country skiers (n = 12), and long-distance runners (n = 3) formed the athlete group, with 39 non-athletes as controls. Big-five personality traits, fear of pain and Grit (perseverance and passion for long-term goals) were measured prior to induction of experimental pain. Pain threshold and intensity was induced by a PC-controlled heat thermode and measured by a computerized visual analog scale. Pain tolerance was measured by the cold pressor test (CPT). Results: Elite and high-level athletes had increased pain tolerance, higher heat pain thresholds, and reported lower pain intensity to thermal stimulation. Endurance athletes (cross country skiers and long-distance runners) had better tolerance for cold pain compared to both soccer-players and non-athletes. Furthermore, endurance athletes reported lower pain intensity compared to non-athletes, whereas both endurance athletes and soccer players had higher heat pain thresholds compared to non-athletes. Fear of Pain was the only psychological trait that had an impact on all pain measures. Conclusion: The present findings suggest that sports with long durations of physically intense activity, leveling aerobic capacity, are associated with increased ability to tolerate pain and that the amount of training hours has an impact on this tolerance. However, the small sample size implies that the results from this study should be interpreted with caution.

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Section: Methodsmentioning

confidence: 99%

Pain Processing in Elite and High-Level Athletes Compared to Non-athletes

2020

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“…Nocebo effects can play an important role when introducing a medication or changing an established medication. There have been interesting investigations concerning treatment of pain, epilepsy, and itch showing the influence of physician–patient communication [ 6 – 8 ]. Gagne et al in 2010 were the first to document that anti-epileptic drug prescription refilling may be associated with an elevated risk of seizure-related events, indicating a pattern independent of any transitioning issues [ 7 ].…”

Section: What Is the Nocebo Effect?mentioning

confidence: 99%

Non-pharmacological Effects in Switching Medication: The Nocebo Effect in Switching from Originator to Biosimilar Agent

et al. 2018

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The nocebo effect is defined as the incitement or the worsening of symptoms induced by any negative attitude from non-pharmacological therapeutic intervention, sham, or active therapies. When a patient anticipates a negative effect associated with an intervention, medication or change in medication, they may then experience either an increase in this effect or experience it de novo. Although less is known about the nocebo effect compared with the placebo effect, widespread interest in the nocebo effect observed with statin therapy and a literature review highlighting the nocebo effect across at least ten different disease areas strongly suggests this is a common phenomenon. This effect has also recently been shown to play a role when introducing a medication or changing an established medication, for example, when switching patients from a reference biologic to a biosimilar. Given the important role biosimilars play in providing cost-effective alternatives to reference biologics, increasing physician treatment options and patient access to effective biologic treatment, it is important that we understand this phenomenon and aim to reduce this effect when possible. In this paper, we propose three key strategies to help mitigate the nocebo effect in clinical practice when switching patients from reference biologic to biosimilar: positive framing, increasing patient and healthcare professionals’ understanding of biosimilars and utilising a managed switching programme.

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“…Connectivity between ACC and fusiform gyrus during painful stimulation decreased in the negative expectancy group, indicating that verbal instructions related to pain deserve further investigation. 71 Startle reflex 3 and electroencephalogram 1 are modulated by negative expectancies and have been associated with nocebo hyperlagesia.…”

Section: Biochemical and Neurophysiological Mechanismsmentioning

confidence: 99%

Nocebo and pain: an overview of the psychoneurobiological mechanisms

Blasini

Corsi

Klinger

et al. 2017

PR9

107

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Introduction Nocebo effects are defined as adverse events related to negative expectations and learning processes that are involved in the modulation of the descending pain pathways. Research over the last couple of decades has illustrated that behavioral, psychoneurobiological and functional changes occur during nocebo-induced pain processing. Objectives We aimed to review published human and non-human research on algesia and hyperalgesia resulting from negative expectations and nocebo effects. Methods Herein, we searched and comprehensively reviewed scientific literature providing informative knowledge about the psychoneurobiological bases of the nocebo effect in the field of pain with an emphasis on how pain processes are shaped by both cognitive and non-cognitive factors. Results Negative expectations are formed through verbal suggestions of heightened pain, prior nociceptive and painful experiences and observation of pain in others. Susceptibility to the nocebo effect can be also influenced by genetic variants, conscious and nonconscious learning processes, personality traits and psychological factors. Moreover, providers’ behaviors, environmental cues and the appearance of medical devices can induce negative expectations that dramatically influence pain perception and processing in a variety of pain modalities and patient populations. Conclusion Importantly, we concluded that nocebo studies outline how individual expectations may lead to physiological changes underpinning the central integration and processing of magnified pain signaling. Further research is needed to develop strategies that can identify nocebo-vulnerable pain patients in order to optimize the psychosocial and therapeutic context in which the clinical encounter occurs, with the ultimate purpose of improving clinical outcomes.

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Nocebo hyperalgesia and the startle response

Abstract: Background: The literature on the effects of nocebo on pain is sparse. The present

Cited by 16 publications

References 37 publications

Pain Processing in Elite and High-Level Athletes Compared to Non-athletes

Pain Processing in Elite and High-Level Athletes Compared to Non-athletes

Non-pharmacological Effects in Switching Medication: The Nocebo Effect in Switching from Originator to Biosimilar Agent

Nocebo and pain: an overview of the psychoneurobiological mechanisms

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